Ideas to help prevent Dementia Physical Activity

As I indicated yesterday, dementia is a serious problem and there are many risk factors for dementia, some are under our control and some are not. However, the existence of potentially modifiable risk factors means that prevention of dementia is possible through a public health approach, including the implementation of key interventions that delay or slow cognitive decline or dementia.

Risk factors for dementia, that are out of our control include age, gender, race/ethnicity and family history.  It is important to note that while age is the strongest known risk factor for cognitive decline, dementia is not a natural or inevitable consequence of ageing.

During the last two decades, several studies have shown a relationship between the development of cognitive impairment and dementia with educational attainment, and lifestyle-related risk factors. These lifestyle risk factors are those we can control. These lifestyles choices are associated with an increased risk of developing dementia, physical inactivity, tobacco use, unhealthy diets and harmful use of alcohol.

In addition to the lifestyle choices certain medical conditions are associated with an increased risk of developing dementia, including hypertension, diabetes, hypercholesterolemia, obesity and depression.

Other areas that may cause an increase risk of dementia includes social isolation and cognitive inactivity. Over time I will look at all of the factors involved that we can control.

Seniors need according to the research about 150 minutes a week of physical activity or about 30 minutes a day, to stay healthy. Studies have linked a physically active lifestyle to good brain health. In large observational studies with follow-up periods extending decades, physically active people seem less likely to develop cognitive decline, all-cause dementia, vascular dementia and Alzheimer's disease when compared with inactive people. Especially, the highest levels of physical exercise seem to be most protective. Physical activity seems to have beneficial effects on brain structures, which may underlie this association.

Being physically active has a positive effect on other modifiable cardiovascular risk factors, such as hypertension, insulin resistance and high cholesterol levels. As well some other positive effects of exercise are enhancing the immune system function, anti-inflammatory properties.

Physical activity for adults 65 years and above, include recreational or leisure-time physical activity, transportation (e.g. walking or cycling), occupational (if the person is still engaged in work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities. In order to improve muscular fitness, bone and functional health, and reduce the risk of depression and cognitive decline, the following guidelines are recommended by the World Health Organization (always check with your doctor before beginning or changing your exercise regime):

If you are aged 65 years and above you should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week.

If you can not find 150 minutes a week then you could also do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity. Aerobic activity should be performed in bouts of at least 10 minutes’ duration.

For additional health benefits, you might consider increasing your moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.

If you have poor mobility you should consider physical activity to enhance balance and prevent falls on 3 or more days per week.

Muscle-strengthening activities should be done involving major muscle groups, on 2 or more days per week.

If you cannot do the recommended amounts of physical activity due to health conditions, you should be as physically active as your abilities and conditions allow.

Overall the benefits of implementing the above recommendations, and of being physically active, outweigh the harms. At the recommended level of 150 minutes per week of moderate-intensity activity, musculoskeletal injury rates appear to be uncommon.

If you are thinking about changing your exercise regime, check with your doctor, but it would be appropriate to start slowly and use gradual progress to move to the higher levels of physical activity.

Dementia is a rapidly growing public health problem

Dementia is a rapidly growing public health problem affecting around 50 million people around the world. There are nearly 10 million new cases every year and this figure is set to triple by 2050.

Dementia is a major cause of disability and dependency among older people and can devastate the lives of affected individuals, their careers and their families. Additionally, the disease inflicts a heavy economic burden on societies as a whole, with the costs of caring for people with dementia estimated to rise to US$ 2 trillion annually by 2030.

While there is no curative treatment for dementia, the proactive management of modifiable risk factors can delay or slow the onset or progression of the disease. In May 2017, the Seventieth World Health Assembly endorsed a Global Action Plan on the Public Health Response to Dementia 2017–2025. Dementia risk reduction is one of the seven action areas in the global action plan. The following is taken from this plan

Dementia is a rapidly growing global public health problem. Worldwide, around 50 million people have dementia, with approximately 60% living in low- and middle-income countries (LMIC). Every year, there are nearly 10 million new cases. The total number of people with dementia is projected to reach 82 million in 2030 and 152 million in 2050. Dementia leads to increased costs for governments, communities, families and individuals, and to the loss in productivity for economies. In 2015, the total global societal cost of dementia was estimated to be US$ 818 billion, equivalent to 1.1% of global gross domestic product (GDP).

Crucially, while age is the strongest known risk factor for cognitive decline, dementia is not a natural or inevitable consequence of ageing. Several recent studies have shown a relationship between the development of cognitive impairment and dementia with lifestyle-related risk factors, such as physical inactivity, tobacco use, unhealthy diets and harmful use of alcohol.

Certain medical conditions are associated with an increased risk of developing dementia, including hypertension, diabetes, hypercholesterolemia, obesity and depression. Other potentially modifiable risk factors include social isolation and cognitive inactivity. The existence of potentially modifiable risk factors means that prevention of dementia is possible through a public health approach, including the implementation of key interventions that delay or slow cognitive decline or dementia. 

Checked your blood pressure lately?

l have a blood pressure machine at home.  I am sure many do, as I have hypertension, and I take blood pressure medication and I check my blood pressure on a regular basis. I have been reading about how is the best way, and the best time to take your blood pressure. So, I went to my instructional booklet and here are some ideas to help you. Always check with your own medical team before you act on any information you see on the net.

Self-measurement means control, not diagnosis or treatment. Your values must always be discussed with your doctor or a physician who is familiar with your family history.

If you are undergoing medical treatment and receiving medication, consult your doctor to determine the most appropriate time to measure your blood pressure. Never alter the dosages of any medication without direction from your doctor.

Your blood pressure depends on several factors, such as age, gender, weight, and physical condition. It also depends on the environment and your state of mind at the time of measurement. In general, your blood pressure is lower when you are asleep and higher when you are active. Your blood pressure may be higher when recorded at a hospital or a clinic and may be lower when measured in the relaxing comfort of your home. Due to these variations, we recommend that you record your blood pressure regularly at home as well as at your doctor’s clinic.

Try to record your blood pressure regularly at the same time of the day and under the same conditions. This will help your physician detect any extreme variations in your blood pressure and thus treat you accordingly.

Recently, several studies have identified elevated cardiovascular risks (heart failure, stroke, angina) associated with “morning hypertension” Morning Hypertension ( > 135 / 85 mm Hg). There is a typical rise in blood pressure during the physiological changes from sleep to arising for the day.

The ideal times to measure your blood pressure is in the morning and at least 2 hours after dinner. Measure just after you wake up, before breakfast and any physical activity, and in the absence of the urge to urinate. If this is not possible, try to take the measurements later in the morning, before you start any physical activity. Relax for 5 minutes before you record your blood pressure.

Your blood pressure increases or decreases under the following circumstances:

Blood pressure is higher than normal:

·       When you are excited, nervous, or tense

·       While taking a bath/shower

·       During and after exercise or strenuous physical activity

·       When it is cold

·       Within two hours after meals

·       After drinking tea, coffee, or other caffeinated drinks

·       After smoking tobacco

·       When your bladder is full

Blood pressure is lower than normal:

·       After consuming alcohol

·       After taking a bath/shower

February is heart month

February is heart month – a time to increase awareness of cardiovascular health and the things that affect it. Heart disease affects approximately 2.4 million Canadian adults and is the second leading cause of death in Canada. There are several factors that contribute to your overall heart health including exercise, diet, and overall lifestyle. McMaster University has put together some of the latest evidence-based resources on five key areas that help you maintain a healthy heart as you age.

1.   Exercise

Here are four research-based examples of the health benefits of walking:

·        Improves heart health. In older adults who were previously inactive, walking for 20-60 minutes per day, 2-7 days per week can reduce some risk factors for heart disease

·        Benefits people with existing chronic conditions. Walking groups can also provide great opportunities to socialize and increase motivation to be more physically active. For older people with chronic conditions like arthritis, dementia, depression, and Parkinson’s disease, walking in groups can improve blood pressure, heart rate, body fat, fitness.

·        Helps with stroke recovery. One to 6 months after a stroke, walking training (including musical feedback and treadmill training) can help to improve walking speed and distance more than traditional walking training. Six or more months after a stroke, any type of walking training helps improve walking ability, speed, and distance.

·        Reduces pain and improves physical function. For people with chronic musculoskeletal pain, walking can improve pain for up to one year. In fact, walking provides more effective pain relief than other common interventions such as education, usual care, other exercise, relaxation, or massage. Walking can also improve overall physical function in chronic pain sufferers.

2.   Eat a healthy, balanced diet

·        Two recent systematic reviews found that the Paleo diet can lead to weight loss, trim the waistline, and lower body mass index. One of these reviews also found that the Paleo diet may impact other risk factors for heart disease by increasing the concentration of certain fats found in the blood like HDL (“good”) cholesterol, and lowering blood pressure, inflammation, and the concertation of other fats like triglycerides, total cholesterol, and LDL (“bad”) cholesterol. It’s also important to note that the reviews themselves were small in terms of the number participants included. In the end.

·        Neither paid much attention to the cons of the Paleo diet, but if you’re thinking of adopting this diet, you should consider them carefully! For example, the Paleo diet cuts out dairy, which may impact your calcium levels, a key element for bone health. If following the Paleo diet, it’s important to ensure you’re getting the needed amount of daily calcium from other food sources. The Paleo diet also recommends getting just one-third of your daily calories from carbohydrates, making it a “low-carb” diet. The safety of diets that restrict carbohydrate consumption to this degree is heavily debated and needs to be assessed further.

3.   Reduce your salt intake

·        Cutting back on salt has been the focus of numerous research studies, including 34 randomized controlled trials involving more than 3,200 people between the ages of 22 and 73. Two thirds had high blood pressure; the rest had normal blood pressure. The average reduction in salt intake was 4,400 mg per day over a minimum of four weeks.

·        Most American adults require no more than 6,000 mg of salt per day, while certain groups like African Americans, adults 51 and over, and people with conditions like hypertension, diabetes and chronic kidney disease should reduce their daily salt intake to 4,000mg.

·        The evidence was strong that reducing salt intake lowers blood pressure in adults, regardless of sex or ethnicity and without any adverse effects. Improvements were greatest in people with high blood pressure (systolic blood pressure decreased an average of 5.39 mm Hg and diastolic blood pressure decreased an average of 2.82 mm Hg) but notable drops were also seen in people with normal blood pressure.

·        The research also suggests that greater reductions in salt intake will likely decrease blood pressure even further. So, if reducing our salt intake is a prudent course of action and one that will significantly lower our risk of heart disease and stroke, what’s the best way to do it? The real culprit, accounting for up to 85% of our salt consumption, is processed foods. A few sausage links or slices of bacon can account for more than half your daily salt limit. Canned foods, cheeses, breads, cereals, sauces and pickles are among the many other foods that are high in sodium.

4.   Maintain good oral health. You can keep your teeth for your lifetime. Here are some things you can do to maintain a healthy mouth and strong teeth.

·        Drink fluoridated water and brush with fluoride toothpaste.

·        Practice good oral hygiene. Brush teeth thoroughly and floss between the teeth to remove dental plaque.

·        Visit your dentist on a regular basis, even if you have no natural teeth or have dentures.

·        Do not use any tobacco products. If you smoke, quit.

·        Limit alcoholic drinks.

·        If you have diabetes, work to maintain control of the disease. This will decrease risk for other complications, including gum disease.

·        If your medication causes dry mouth, ask your doctor for a different medication that may not cause this condition. If dry mouth cannot be avoided, drink plenty of water, chew sugarless gum, and avoid tobacco products and alcohol.

·        See your doctor or a dentist if you have sudden changes in taste and smell.

·        When acting as a caregiver, help older individuals brush and floss their teeth if they are not able to perform these activities independently.

5     Don’t rely on supplements. Some say, “Without your health you have nothing”. This might explain why three-quarters of us take dietary supplements with the hope of boosting our health.

Clearly, we are a captive market. The challenge comes in teasing out which health claims are true. In some cases, such as in those with certain health conditions or a poor diet, supplements may be a beneficial strategy. Dietary supplements, however, are not closely regulated, and many have failed to live up to their promises of preventing or reversing chronic diseases. Aside from the costs, taking supplements can lead us to adopt a supplement regimen that is potentially dangerous or interferes with our prescribed medications

Ultimately, regardless of whether different dietary supplements are backed by evidence or not, always be sure to consult your health care provider or pharmacist before using them to tackle your health woes. These discussions will help you understand the potential positive and negative impacts on your health as an individual, especially since vitamins aren’t safe for everyone.